Associations between acute glucose control and peripheral nerve structure and function in type 1 diabetes.
Adult
Blood Glucose
/ metabolism
Blood Glucose Self-Monitoring
Cornea
/ innervation
Diabetes Mellitus, Type 1
/ drug therapy
Female
Humans
Hypoglycemic Agents
/ therapeutic use
Insulin
/ therapeutic use
Intravital Microscopy
Male
Microscopy, Confocal
Middle Aged
Monitoring, Ambulatory
Neural Conduction
Organ Size
Peripheral Nerves
/ pathology
Young Adult
Journal
Diabetic medicine : a journal of the British Diabetic Association
ISSN: 1464-5491
Titre abrégé: Diabet Med
Pays: England
ID NLM: 8500858
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
accepted:
09
04
2020
pubmed:
17
4
2020
medline:
5
10
2021
entrez:
17
4
2020
Statut:
ppublish
Résumé
To examine the associations between continuous overlapping net glycaemic action (CONGA), percentage time in hyperglycaemia (%HG) or normoglycaemia (%NG) and peripheral nerve structure and function in type 1 diabetes. Twenty-seven participants with type 1 diabetes underwent continuous glucose monitoring followed by corneal confocal microscopy and nerve excitability assessments. CONGA, %HG (> 10.0 mmol/l) and %NG (3.9-10.0 mmol/l) were correlated against corneal nerve fibre length and density in the central cornea and inferior whorl region, corneal microneuromas, and a nerve excitability score while controlling for age, sex, diabetes duration and HbA An increase in CONGA [median 2.5 (2.0-3.1) mmol/l] or %HG (mean 46 ± 18%) was associated with a worse nerve excitability score (r = -0.433, P = 0.036 and r = -0.670, P = 0.0012, respectively). By contrast, greater %NG (51 ± 17%) correlated with better nerve excitability scores (r = 0.672, P = 0.0011). Logistic regression revealed that increasing %HG increased the likelihood of abnormal nerve function [odds ratio (OR) 1.11, 95% confidence interval (CI) 1.01-1.23; P = 0.037). An increase in CONGA and %HG were associated with worsening nerve conduction measures, whereas longer %NG correlated with improved nerve conduction variables. CONGA and %HG were associated with inferior whorl corneal nerve fibre length (r = 0.483, P = 0.034 and r = 0.591, P = 0.021, respectively) and number of microneuromas (r = 0.433, P = 0.047 and r = 0.516, P = 0.020, respectively). Short-term measures of glucose control are associated with impaired nerve function and alterations in corneal nerve morphology.
Substances chimiques
Blood Glucose
0
Hypoglycemic Agents
0
Insulin
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1553-1560Subventions
Organisme : National Health and Medical Research Council
ID : 1091006
Pays : International
Informations de copyright
© 2020 Diabetes UK.
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